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Conservative versus aggressive follow up of mildly abnormal Pap smears: Testing for process utility

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  • Stephen Birch
  • Joy Melnikow
  • Miriam Kuppermann

Abstract

Economic evaluation generally limits outcome measurement to the valuation of health outcomes produced by interventions without considering the impact of processes on utility. We test for process utility by comparing utility measurements for alternative approaches to managing abnormal Pap smears in the context of a fixed outcome. The impact of health care interventions on individual well‐being was not confined to health outcomes. Aggressive and conservative follow‐up approaches were associated with statistically significant differences in utilities. We also found that relative preferences among different processes may depend on the particular circumstances or pathologies being considered. Copyright © 2003 John Wiley & Sons, Ltd.

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  • Stephen Birch & Joy Melnikow & Miriam Kuppermann, 2003. "Conservative versus aggressive follow up of mildly abnormal Pap smears: Testing for process utility," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 879-884, October.
    • Handle: RePEc:wly:hlthec:v:12:y:2003:i:10:p:879-884
    DOI: 10.1002/hec.783
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    References listed on IDEAS

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    Cited by:

    1. Brouwer, Werner B.F. & Exel, N. Job A. van & Berg, Bernard van den & Bos, Geertruidis A.M. van den & Koopmanschap, Marc A., 2005. "Process utility from providing informal care: the benefit of caring," Health Policy, Elsevier, vol. 74(1), pages 85-99, September.
    2. Katherine Payne & Marion McAllister & Linda M. Davies, 2013. "Valuing The Economic Benefits Of Complex Interventions: When Maximising Health Is Not Sufficient," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 258-271, March.
    3. Ryan, Mandy & Kinghorn, Philip & Entwistle, Vikki A. & Francis, Jill J., 2014. "Valuing patients' experiences of healthcare processes: Towards broader applications of existing methods," Social Science & Medicine, Elsevier, vol. 106(C), pages 194-203.
    4. Gafni, Amiram & Birch, Stephen, 2006. "Incremental cost-effectiveness ratios (ICERs): The silence of the lambda," Social Science & Medicine, Elsevier, vol. 62(9), pages 2091-2100, May.
    5. Tianviwat, Sukanya & Chongsuvivatwong, Virasakdi & Birch, Stephen, 2008. "Prevention versus cure: Measuring parental preferences for sealants and fillings as treatments for childhood caries in Southern Thailand," Health Policy, Elsevier, vol. 86(1), pages 64-71, April.
    6. Kirsten Howard & Glenn Salkeld & Kirsten McCaffery & Les Irwig, 2008. "HPV triage testing or repeat Pap smear for the management of atypical squamous cells (ASCUS) on Pap smear: is there evidence of process utility?," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 593-605, May.
    7. Lin Li & J L (Hans) Severens & Olena Mandrik, 2019. "Disutility associated with cancer screening programs: A systematic review," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-17, July.
    8. Brouwer, Werner B.F. & Culyer, Anthony J. & van Exel, N. Job A. & Rutten, Frans F.H., 2008. "Welfarism vs. extra-welfarism," Journal of Health Economics, Elsevier, vol. 27(2), pages 325-338, March.
    9. Lidia Engel & Stirling Bryan & David G. T. Whitehurst, 2021. "Conceptualising ‘Benefits Beyond Health’ in the Context of the Quality-Adjusted Life-Year: A Critical Interpretive Synthesis," PharmacoEconomics, Springer, vol. 39(12), pages 1383-1395, December.
    10. Richard Abreu Lourenco & Marion Haas & Jane Hall & Rosalie Viney, 2017. "Valuing Meta-Health Effects for Use in Economic Evaluations to Inform Reimbursement Decisions: A Review of the Evidence," PharmacoEconomics, Springer, vol. 35(3), pages 347-362, March.
    11. Sukanya Tianviwat & Virasakdi Chongsuvivatwong & Stephen Birch, 2008. "Different dental care setting: does income matter?," Health Economics, John Wiley & Sons, Ltd., vol. 17(1), pages 109-118, January.

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